How to Integrate Pharmacotherapy for Substance Use Disorders at Your Mental Health Clinic

A Step-By-Step Guide for Screening and Treating Adults with Co-Occurring Mental Illness and Alcohol and/or Opioid Use Disorders with Pharmacotherapy in Mental Health Clinics

by Katherine E. Watkins, Allison J. Ober, Sarah B. Hunter, Brian Hurley, John Sheehe, Jeremy Martinez, Elizabeth Bromley, Derjung M. Tarn, Ivan Beas, Alanna Montero, et al.

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Most people with co-occurring substance use and mental health disorders (COD) never get the high-quality care they need to recover. However, research shows that medications for COD can help clients achieve better outcomes. Delivering these medications in a setting where people with COD get most of their care can help increase uptake. To address this issue, RAND researchers created a toolkit to support the delivery of effective, evidence-based pharmacotherapy for clients with co-occurring alcohol use disorder (COD-alcohol) and co-occurring opioid use disorder (COD-opioid) within mental health clinics. The toolkit also guides supportive care, including screening and behavioral therapy, as well as program implementation and monitoring.

Users of the toolkit follow a four-step process to successfully integrate a COD-alcohol or COD-opioid care program in their mental health clinics. In Step 1, users identify key team members and learn how to engage them in implementing an integrated care program. In Step 2, users become familiar with the COD-alcohol or COD-opioid treatment workflow, decide which staff members will be responsible for each step of the process, and adapt the workflow to meet the specific needs of their clinics and care systems. In Step 3, users gather all of the resources needed to provide care in their clinics and assign and train staff on their roles. Finally, in Step 4, users begin treating clients with pharmacotherapy for their COD-alcohol or COD-opioid and monitoring their success.

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This research was prepared for the National Institute on Alcohol Abuse and Alcoholism and conducted by RAND Health Care.

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